1. Field of Invention
The present invention relates to a tubular endoprosthesis, of the type comprising a flexible tubular skirt designed to channel a body fluid.
2. Description of Related Prior Art
At present it is known practice to treat aneurysms of the arterial or venous network by fitting an endoprosthesis in the region of a widened diameter of the network. In order to lessen the impact of the surgical intervention on the patient, it is known to perform celioscopic surgery or endoluminal surgery. In this technique, the surgeon operates inside the body via a small orifice through which the instruments are introduced, thereby avoiding the need to make a large incision in the region to be operated on.
For endoluminal treatment of aneurysms situated in immediate proximity to a bifurcation of the arterial or venous network, it is known to fit an endoluminal prosthesis which has a general Y-shape. This endoprosthesis comprises a trunk which extends through the aneurysm. The trunk is continued by two branches, each being introduced into a derivation situated near the aneurysm.
In the endoluminal intervention for fitting the Y-shaped prosthesis, the prosthesis is first introduced by way of a catheter into the network to be treated, the prosthesis being in a folded-up position.
The surgeon then has to deploy the prosthesis when the latter has been released from the catheter in the aneurysm.
The positioning of the trunk of the prosthesis and of each of its branches in the two bifurcations of the arterial or venous network is an extremely delicate operation for the surgeon since he has to operate remotely using long filiform instruments introduced into the network, and he must do this without a direct view of the operating site.
The object of the invention is to make available an endoprosthesis and an endoluminal operating kit permitting treatment of an aneurysm situated in proximity to a derivation, without the surgeon having excessive difficulty in fitting the endoprosthesis.
To this end, the invention concerns a tubular endoprosthesis of the aforementioned type, characterized in that it comprises a collar for connection of the skirt through a lateral wall of a tubular conduit. The connection collar is initially joined to one end of the skirt and has, at its periphery, elements for securing it to the wall. The securing elements are deformable between an initial docking position and a final connection position.
According to particular embodiments, the endoprosthesis includes one or more of the following characteristics:
the securing elements are designed to bear against a face of the wall in their final connection position;
the securing elements are elements which are plastically deformable from their initial docking position to their final connection position;
the securing elements are elements with centrifugal radial expansion from their initial docking position to their final connection position;
each securing element comprises an arm which has two consecutive segments joined to one another via a region of articulation, and each arm is deformable from an initial docking position, in which the two segments are spaced apart and extend substantially along a generatrix of the endoprosthesis, to a final connection position in which the two segments are folded in towards one another;
the collar has at least two continuous rings which are centered on the axis of the endoprosthesis and to which each of the securing elements is joined, and the rings are displaceable axially between a spaced-apart position, in which the securing elements are in their initial docking position, and a closed-together position in which the securing elements are in their final connection position;
the connection collar has plastically deformable bridges designed for radial expansion of the connection collar from a first configuration, in which the connection collar has an initial diameter, to a second configuration in which the connection collar has a diameter greater than its initial diameter;
the plastically deformable bridges each have a general arch shape and extend along the periphery of the connection collar, which bridges are deformable from an initial position, in which each arch is closed, the connection collar being in its first configuration, and a final position in which each arch is opened, the connection collar being in its second configuration; and
the connection collar comprises, axially, first and second successive crowns which continue the tubular skirt, each crown having securing elements, the elements of the first crown being designed to cooperate with the inner face of the wall of the tubular conduit, and the elements of the second crown being designed to cooperate with the outer face of the wall of the tubular conduit.
The invention also concerns an endoluminal operating kit comprising an endoprosthesis as defined above, a filiform pusher designed to cooperate with the connection collar, and a filiform member for retention of the connection collar.
According to particular embodiments, the endoluminal operating kit includes one or more of the following characteristics:
it additionally comprises a toroidal inflatable balloon with radial expansion; and
it additionally comprises a first endoprosthesis intended to form the tubular conduit to which the tubular endoprosthesis is fastened.
Finally, it concerns a bifurcated bypass prosthesis comprising a first endoprosthesis to which an endoprosthesis as defined above is connected.